Effectiveness of Proactive Tobacco Cessation Treatment Outreach Among Smokers With Serious Mental Illness
Abstract
Introduction: People with serious mental illness (SMI) have a high smoking prevalence and low quit rates. Few cessation treatments are tested in smokers with SMI. Mental health (MH) providers are reluctant to address smoking. Proactive tobacco cessation treatment strategies reach out directly to smokers to offer counseling and medication and improve treatment utilization and quit rates. The current study is a secondary analysis of a randomized controlled trial of proactive outreach for tobacco cessation treatment in VA MH patients. Aims and Methods: Participants (N = 1938, 83% male, mean age 55.7) across four recruitment sites, who were current smokers and had a MH visit in the past 12 months, were identified using the electronic medical record. Participants were randomized to Intervention (telephone outreach call plus invitation to engage in MH tailored telephone counseling and assistance obtaining nicotine replacement therapy) or Control (usual care). The current study assessed outcomes in participants with SMI (N = 982). Results: Compared to the Control group, participants assigned to the Intervention group were more likely to engage in telephone counseling (22% vs. 3%) and use nicotine replacement therapy (51% vs. 41%). Participants in the Intervention group were more likely to be abstinent (7-day point prevalence; 18%) at 12 months than participants in the Control group (11%) but equally likely to make quit attempts. Conclusions: Proactive tobacco cessation treatment is an effective strategy for tobacco users with SMI. Proactive outreach had a particularly strong effect on counseling utilization. Future randomized clinical trials examining proactive tobacco treatment approaches in SMI treatment settings are needed. Implications: Few effective treatment models exist for smokers with SMI. Proactive tobacco cessation outreach with connections to MH tailored telephone counseling and medication promotes tobacco abstinence among smokers with SMI and is an effective treatment strategy for this underserved population.
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Evidence-based telephone-delivered smoking cessation interventions can be efficacious but have yielded relatively low cessation rates among people with mental health disorders, typically ranging from 3% to 18%.
“Although evidence-based telephone-delivered smoking cessation interventions can be efficacious [33], they have yielded relatively low cessation rates among people with mental health disorders, typically ranging from 3% to 18% [33, 34, 35, 36, 37].”
From Can an Acceptance and Commitment Therapy-Based Smartphone App Help Individuals with Mental Health Disorders Quit Smoking? (2024) · cites this paper as [34]
Our study achieved a high 86.1% retention rate at 12 months, exceeding typical rates in smoking cessation trials among individuals with mental health disorders.
“Our study achieved a high 86.1% retention rate at 12 months, exceeding typical rates in smoking cessation trials among individuals with mental health disorders [33, 34].”
From Can an Acceptance and Commitment Therapy-Based Smartphone App Help Individuals with Mental Health Disorders Quit Smoking? (2024) · cites this paper as [34]
In a secondary analysis of that RCT focused on participants with serious mental illness, cigarette smoking abstinence rates were 17.6% for intervention vs 10.6% for control (P<0.01).
“A subsequent secondary analysis of this RCT, focused on participants with serious mental illness [34], revealed cigarette smoking abstinence rates of 17.6% for the intervention group compared to 10.6% for the control group (P < 0.01).”
From Can an Acceptance and Commitment Therapy-Based Smartphone App Help Individuals with Mental Health Disorders Quit Smoking? (2024) · cites this paper as [34]
Cites
The PHQ-8 as a measure of current depression in the general population
Kroenke, K., Strine, T. W., Spitzer, R. L., Williams, J. B. W., Berry, J. T., & Mokdad, A. H. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2008.06.026 · Cited by 5,121 · see citing works
Treating tobacco use and dependence-Clinical practice guideline
Mc, F. (2000) · Medical Entomology and Zoology · Cited by 3,616 · see citing works
Kessler, R. C., Green, J. G., Gruber, M. J., Sampson, N. A., Bromet, E., Cuitan, M., Furukawa, T. A., Gureje, O., Hinkov, H., Hu, C., et al. (2010) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.310 · Cited by 1,434 · see citing works
Heatherton, T. F., Kozlowski, L. T., Frecker, R. C., Rickert, W. S., & Robinson, J. C. (1989) · British Journal of Addiction · doi:10.1111/j.1360-0443.1989.tb03059.x · Cited by 1,316 · see citing works
(2006) · Europe PMC (PubMed Central) · Cited by 1,299 · see citing works
Treating tobacco use and dependence: 2008 update: Clinical practice guideline
(2008) · PsycEXTRA Dataset · doi:10.1037/e481882008-001 · Cited by 1,219 · see citing works
Anthenelli, R. M., Benowitz, N. L., West, R., St Aubin, L., McRae, T., Lawrence, D., Ascher, J., Russ, C., Krishen, A., & Evins, A. E. (2016) · The Lancet · doi:10.1016/s0140-6736(16)30272-0 · Cited by 1,177 · see citing works
Prochaska, J. J., Sung, H., Max, W., Shi, Y., & Ong, M. (2012) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.1349 · Cited by 942 · see citing works
Tobacco Product Use Among Adults — United States, 2017
Wang, T. W., Asman, K., Gentzke, A. S., Cullen, K. A., Holder-Hayes, E., Reyes-Guzman, C. M., Jamal, A., Neff, L. J., & King, B. A. (2018) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6744a2 · Cited by 669 · see citing works
Cook, B. L., Wayne, G. F., Kafali, E. N., Liu, Z., Shu, C., & Flores, M. (2014) · JAMA · doi:10.1001/jama.2013.284985 · Cited by 519 · see citing works
McClave, A. K., McKnight-Eily, L. R., Davis, S. P., & Dube, S. R. (2010) · American Journal of Public Health · doi:10.2105/ajph.2009.188136 · Cited by 339 · see citing works
Assessing motivation to quit smoking in people with mental illness: a review
Siru, R., Hulse, G. K., & Tait, R. J. (2009) · Addiction · doi:10.1111/j.1360-0443.2009.02545.x · Cited by 301 · see citing works
Dickerson, F., Stallings, C. R., Origoni, A. E., Vaughan, C., Khushalani, S., Schroeder, J. R., & Yolken, R. H. (2012) · Psychiatric Services · doi:10.1176/appi.ps.201200143 · Cited by 248 · see citing works
Serious Cardiovascular Events and Mortality Among Patients with Schizophrenia
Enger, C. L., Weatherby, L. B., Reynolds, R. F., Glasser, D. B., & Walker, A. M. (2003) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000105996.62105.07 · Cited by 215 · see citing works
Prochaska, J. J. (2010) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2010.03.002 · Cited by 192 · see citing works
Cigarette Smoking by Patients With Serious Mental Illness, 1999–2016: An Increasing Disparity
Dickerson, F., Schroeder, J. R., Katsafanas, E., Khushalani, S., Origoni, A. E., Savage, C. L. G., Schweinfurth, L. A. B., Stallings, C. R., Sweeney, K., & Yolken, R. H. (2017) · Psychiatric Services · doi:10.1176/appi.ps.201700118 · Cited by 191 · see citing works
Chwastiak, L., Rosenheck, R. A., & Kazis, L. E. (2011) · Psychosomatics · doi:10.1016/j.psym.2010.12.009 · Cited by 182 · see citing works
Steinberg, M. L., Ziedonis, D. M., Krejci, J. A., & Brandon, T. H. (2004) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.72.4.723 · Cited by 169 · see citing works
Smoking cessation and reduction in people with chronic mental illness
Tidey, J. W., & Miller, M. E. (2015) · BMJ · doi:10.1136/bmj.h4065 · Cited by 165 · see citing works
Smoking and the Reduced Life Expectancy of Individuals With Serious Mental Illness
Tam, J., Warner, K. E., & Meza, R. (2016) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2016.06.007 · Cited by 153 · see citing works
Proactive Tobacco Treatment and Population-Level Cessation
Fu, S. S., van Ryn, M., Sherman, S. E., Burgess, D. J., Noorbaloochi, S., Clothier, B. A., Taylor, B. C., Schlede, C. M., Burke, R. S., & Joseph, A. M. (2014) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2014.177 · Cited by 110 · see citing works
Self-citationTreatment of Tobacco Use Disorders in Smokers with Serious Mental Illness
Evins, A. E., Cather, C., & Laffer, A. (2015) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000063 · Cited by 86 · see citing works
Poor Mental Health and Reduced Decline in Smoking Prevalence
Steinberg, M. L., Williams, J. M., & Li, Y.-Q. (2015) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2015.01.016 · Cited by 84 · see citing works
Fu, S. S., van Ryn, M., Nelson, D. B., Burgess, D. J., Thomas, J., Saul, J. E., Clothier, B. A., Nyman, J. A., Hammett, P. J., & Joseph, A. M. (2016) · Thorax · doi:10.1136/thoraxjnl-2015-207904 · Cited by 79 · see citing works
Self-citationIbrahim, J. G., & Lipsitz, S. R. (1996) · Biometrics · doi:10.2307/2533068 · Cited by 77 · see citing works
Shorter, G. W. (2013) · Cited by 76 · see citing works
Morris, C. D., Waxmonsky, J. A., May, M. G., Tinkelman, D. G., Dickinson, M., & Giese, A. A. (2011) · Community Mental Health Journal · doi:10.1007/s10597-011-9411-z · Cited by 61 · see citing works
Baker, A., RICHMOND, R. L., KAY‐LAMBKIN, F. J., Filia, S., Castle, D. J., Williams, J. M., Lewin, T. J., Clark, V. L., Callister, R., & Weaver, N. (2015) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntv039 · Cited by 59 · see citing works
Das, S., & Prochaska, J. J. (2017) · Expert Review of Respiratory Medicine · doi:10.1080/17476348.2017.1361823 · Cited by 59 · see citing works
Rogers, E., & Sherman, S. E. (2013) · American Journal of Public Health · doi:10.2105/ajph.2013.301584 · Cited by 55 · see citing works
Self-citationWilliams, J. M., Steinberg, M. L., Zimmermann, M. H., Gandhi, K. K., Stipelman, B. A., Budsock, P. D., & Ziedonis, D. M. (2010) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2010.03.006 · Cited by 54 · see citing works
Telephone Smoking-Cessation Counseling for Smokers in Mental Health Clinics
Rogers, E. S., Smelson, D. A., Gillespie, C. C., Elbel, B., Poole, S., Hagedorn, H. J., Kalman, D., Krebs, P., Fang, Y., Wang, B., et al. (2016) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2015.10.004 · Cited by 47 · see citing works
Self-citationEvaluation of the CHOICES Program of Peer-to-Peer Tobacco Education and Advocacy
Williams, J. M., Dwyer, M., Verna, M., Zimmermann, M. H., Gandhi, K. K., Galazyn, M., Szkodny, N., Molnar, M., Kley, R., & Steinberg, M. L. (2010) · Community Mental Health Journal · doi:10.1007/s10597-010-9310-8 · Cited by 46 · see citing works
Dixon, L. B., Medoff, D. R., Goldberg, R. W., Lucksted, A. A., Kreyenbuhl, J. A., DiClemente, C. C., Potts, W., Leith, J. E., Brown, C. H., Adams, C., et al. (2009) · American Journal on Addictions · doi:10.3109/10550490903077747 · Cited by 45 · see citing works
Smoking Use and Cessation Among People with Serious Mental Illness.
Annamalai, A., Singh, N., & O’Malley, S. S. (2015) · PubMed Central · Cited by 42 · see citing works
Outcome from a Community-based Smoking Cessation Program for Persons with Serious Mental Illness
Currie, S. R., Karltyn, J., Lussier, D., de Denus, E., Brown, D., & el‐Guebaly, N. (2007) · Community Mental Health Journal · doi:10.1007/s10597-007-9113-8 · Cited by 31 · see citing works
Helping smokers with depression to quit smoking: collaborative care with Quitline
Segan, C., Borland, R., Wilhelm, K. A., Bhar, S. S., Hannan, A. T., Dunt, D. R., & Ferretter, I. T. (2011) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.2011.tb03258.x · Cited by 29 · see citing works
Cessation Among State Quitline Participants with a Mental Health Condition
Kerkvliet, J. L., Wey, H., & Fahrenwald, N. L. (2015) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntu239 · Cited by 29 · see citing works
A Wellness Approach to Addressing Tobacco in Mental Health Settings: Learning About Healthy Living
Williams, J. M., Ziedonis, D. M., Vreeland, B., Edwards, N. S., Zechner, M., Williams, M. T., Rahim, R. N., KARIMI, L., Molnar, M., & Eilers, R. D. (2009) · American Journal of Psychiatric Rehabilitation · doi:10.1080/15487760903248580 · Cited by 28 · see citing works
Dickerson, F., Savage, C. L. G., Schweinfurth, L. A. B., Medoff, D. R., Goldberg, R. W., Bennett, M. E., Lucksted, A. A., Chinman, M., Daumit, G. L., Dixon, L. B., et al. (2015) · Psychiatric Rehabilitation Journal · doi:10.1037/prj0000161 · Cited by 27 · see citing works
Nair, U. S., Bell, M. L., Yuan, N. P., Wertheim, B. C., & Thomson, C. A. (2018) · Public Health Reports · doi:10.1177/0033354918764903 · Cited by 18 · see citing works
Bennett, M. E., Brown, C. H., Li, L., Himelhoch, S. S., Bellack, A. S., & Dixon, L. B. (2015) · Journal of Dual Diagnosis · doi:10.1080/15504263.2015.1104481 · Cited by 15 · see citing works
Carpenter, K., Nash, C. M., Vargas-Belcher, R. A., Vickerman, K. A., & Haufle, V. (2019) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntz023 · Cited by 15 · see citing works
Ferron, J. C., Devitt, T. S., McHugo, G. J., Jonikas, J. A., Cook, J. Α., & Brunette, M. F. (2016) · Community Mental Health Journal · doi:10.1007/s10597-016-9998-1 · Cited by 10 · see citing works
Japuntich, S. J., Sherman, S. E., Joseph, A. M., Clothier, B. A., Noorbaloochi, S., Danan, E. R., Burgess, D. J., Rogers, E., & Fu, S. S. (2017) · Addictive Behaviors · doi:10.1016/j.addbeh.2017.07.024 · Cited by 6 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Weinberger, A. H., Zhu, J., Barrington‐Trimis, J. L., Wyka, K., & Goodwin, R. D. (2020) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntaa061 · Cited by 45 · see citing works
Evins, A. E., Cather, C., Maravić, M. C., Reyering, S., Pachas, G. N., Thorndike, A. N., Levy, D. E., Fung, V., Fischer, M. A., Schnitzer, K., et al. (2022) · Psychiatric Services · doi:10.1176/appi.ps.20220187 · Cited by 21 · see citing works
Daumit, G. L., Evins, A. E., Cather, C., Dalcin, A. T., Dickerson, F. B., Miller, E. R., Appel, L. J., Jerome, G. J., McCann, U., Ford, D. E., et al. (2023) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2023.1691 · Cited by 13 · see citing works
A community-based tobacco cessation program for individuals experiencing homelessness
Hartman-Filson, M., Chen, J., Lee, P., Phan, M., Apollonio, D. E., Kroon, L. A., Donald, F., & Vijayaraghavan, M. (2022) · Addictive Behaviors · doi:10.1016/j.addbeh.2022.107282 · Cited by 13 · see citing works
Khadjesari, Z., Brown, T. J., Ramsey, A. T., Goodfellow, H., El‐Toukhy, S., Abroms, L. C., Jopling, H., Viik, A. D., & Amato, M. S. (2022) · JMIR Formative Research · doi:10.2196/34271 · Cited by 9 · see citing works
Marel, C., Siedlecka, E., Wilson, J., Rochesson, S. E. D., Chu, D., Fisher, A. C., & Mills, K. L. (2025) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/00048674251321272 · Cited by 7 · see citing works
Busch, A. M., Nederhoff, D. M., DUNSIGER, S. I., Japuntich, S. J., Chrastek, M., Adkins-Hempel, M., Rinehart, L., & Lando, H. A. (2021) · BMC Psychiatry · doi:10.1186/s12888-021-03113-5 · Cited by 5 · see citing works
Self-citation“It's the one thing they have left”: smoking, smoking cessation and mental health
Stockings, E., Metse, A. P., & Taylor, G. M. J. (2021) · European Respiratory Society eBooks · doi:10.1183/2312508x.10003420 · Cited by 4 · see citing works
Japuntich, S. J., Adkins-Hempel, M., Lundtvedt, C., Becker, S. J., Helseth, S. A., Fu, S. S., Tidey, J. W., Evins, A. E., & Pratt, R. J. (2022) · Journal of Dual Diagnosis · doi:10.1080/15504263.2022.2090647 · Cited by 4 · see citing works
Self-citationCarpenter, M. J., & Hughes, J. R. (2020) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntaa062 · Cited by 3 · see citing works
Santiago-Torres, M., Mull, K. E., Sullivan, B. M., Prochaska, J. J., Zvolensky, M. J., & Bricker, J. B. (2024) · Depression and Anxiety · doi:10.1155/2024/1055801 · Cited by 3 · see citing works
“A subsequent secondary analysis of this RCT, focused on participants with serious mental illness [34], revealed cigarette smoking abstinence rates of 17.6 % for the intervention group compared to 10.6 % for the control group ( P 0 : 01).”
InfluentialWorni-Schudel, I. M., Tzalis, V., Jakob, J., Tal, K., Gilgien-Dénéréaz, L., Gencer, B., Matter, C. M., Lüscher, T. F., Windecker, S., Mach, F., et al. (2021) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2021.101583 · Cited by 1 · see citing works
Swong, S., NICHOLSON, A. C., Smelson, D. A., Rogers, E., Shahawy, O. E., & Sherman, S. E. (2023) · BMC Public Health · doi:10.1186/s12889-023-16975-z · Cited by 1 · see citing works
Self-citationMartínez, C., Feliu, A., Saura, J., Nieva, G., Pinet, C., Raich, A., Mondón, S., Barrio, P., Andreu, M., Hernández‐Ribas, R., et al. (2024) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-024-01254-8 · Cited by 1 · see citing works
Feasibility Pilot Study of an Opioid Helpline for Individuals at High Risk for Opioid Use Disorder
Tiouririne, N. A., Coley, J., Kalelioğlu, T., & Schorling, K. (2022) · Journal of Addiction Medicine · doi:10.1097/adm.0000000000001086 · Cited by 1 · see citing works
Mental Illness and Tobacco Usage
Asharani, P. V., & Subramaniam, M. (2022) · Springer eBooks · doi:10.1007/978-3-030-92392-1_41 · Cited by 1 · see citing works
Evins, A. E., Cather, C., Maravić, M. C., Reyering, S., Pachas, G. N., Thorndike, A. N., Levy, D. E., Fung, V., Fischer, M. A., Schnitzer, K., et al. (2022) · SSRN Electronic Journal · doi:10.2139/ssrn.4047139
Mental Illness and Tobacco Usage
Asharani, P. V., & Subramaniam, M. (2022) · Springer eBooks · doi:10.1007/978-3-030-67928-6_41-1
Abufarsakh, B., Scarduzio, J. A., & Okoli, C. T. C. (2023) · Issues in Mental Health Nursing · doi:10.1080/01612840.2023.2255261
Keizer, I., Eytan, A., Khan, A. N., & Papachristou, C. (2024) · Psychology · doi:10.4236/psych.2024.152015
Chapter 8. Engaging Individuals Into Treatment
(2024) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9798894550787.lg08
Worsdale, A., Gilliam, M., Kowitt, S. D., Steinberg, M. L., Goldstein, A. O., & Byron, M. (2026) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntag192
- Authors
- Japuntich, S. J., Hammett, P. J., Rogers, E. S., Fu, S., Burgess, D. J., El Shahawy, O., Melzer, A. C., Noorbaloochi, S., Krebs, P., & Sherman, S. E.
- Affiliations
- Department of Clinical Pharmacology and Toxicology, Hennepin Healthcare, Minneapolis, MN
- University of Minnesota (US)
- VA NY Harbor Healthcare System (US)
- Department of Population Health, New York University School of Medicine, New York, NY
- VA San Diego Healthcare System (US)
- Corresponding author
- Japuntich, Sandra J
- ORCID
- Venue
- Nicotine & Tobacco Research
- Publisher
- Oxford University Press (OUP)
- Published
- 2020-01-20
- Volume
- 22
- Issue
- 9
- Pages
- 1433-1438
- ISSN
- 1462-2203 (ISSN-L)
- 1469-994X
- OpenAlex
- W3002839298
- Cited by
- 23
- References
- 45
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 4 · 2023: 3 · 2022: 9 · 2021: 3 · 2020: 2
- FWCI
- 2.56
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nicotine & Tobacco Research (publishedVersion, public-domain)
- PubMed (publishedVersion)
- Funders
- Veterans Affairs Health Services Research and Development (IIR-11–291)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- tobacco cessation, severe mental illness, proactive outreach, telephone counseling, nicotine replacement therapy, tobacco dependence treatment, smoking abstinence, veterans, mental health professionals, treatment utilization
- MeSH terms
- Smokers, Mental Disorders, Counseling, Female, Humans, Male, Middle Aged, Telephone, Tobacco Use Disorder, United States, Treatment Outcome, Tobacco Use Cessation, Electronic Health Records, Tobacco Use Cessation Devices
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